Residency training in the time of COVID-19: A framework for academic medical centers dealing with the pandemic.

Background: As cases of COVID-19 climb worldwide, academic medical centers (AMCs) are scrambling to balance the increasing demand for medical services while maintaining safe learning environments. The scale and nature of the current pandemic, limitations on key resources, risks of transmission, and the impact on trainee wellbeing pose additional challenges to AMCs. We propose a framework for AMCs to utilize in facilitating health system, organization and program-level adjustments to meet the needs of medical trainees during the pandemic.

Economic Analysis of Using Free Fat Graft or Acellular Dermis to Prevent Post-parotidectomy Frey Syndrome.

A decision tree was constructed to determine the incremental cost-effectiveness ratio (ICER) of grafting techniques used to prevent Frey Syndrome. The authors performed a sensitivity analysis to calculate what the probability of preventing Frey Syndrome would have to be and maximum costs associated with using grafting techniques to warrant their use as more "cost-effective" choice than using neither. Decision pathways utilized were uses of (1) free fat graft (FFG), (2) acellular dermis, and (3) no grafting.

Rattled: Analysis of Facial Trauma Among Toddlers.

Objective: The aim of this study was to determine the national incidence of facial trauma among toddlers and delineate patterns of injury and their causes.

Methods: A retrospective review was designed to explore patterns of maxillofacial trauma within toddler-aged children using the National Electronic Injury Surveillance System from the Consumer Product Safety Commission. The database was searched for emergency department visits involving facial trauma sustained by children 12 months through 3 years of age from 2010 through 2014 and analyzed for patient demographics, primary diagnosis, and associated products/activities.

Analysis of Factors Associated With Rhytidectomy Malpractice Litigation Cases.

Importance: This study investigates the financial burden of medical malpractice litigation associated with rhytidectomies, as well as factors that contribute to litigation and poor defendant outcomes, which can help guide physician practices.

Objective: To comprehensively evaluate rhytidectomy malpractice litigation.

Data Sources And Study Selection: Jury verdict and settlement reports related to rhytidectomy malpractice litigations were obtained using the Westlaw Next database.

To image or not to image? A cost-effectiveness analysis of MRI for patients with asymmetric sensorineural hearing loss.

Objectives/hypothesis: Our objective was to perform an economic analysis evaluating whether ordering a magnetic resonance imaging (MRI) is a cost-effective practice in the workup of undifferentiated asymmetric sensorineural hearing loss (ASNHL). Use of T1 gadolinium-weighted MR (GdT1W) and T2 weighted MR without contrast (T2MR) was each examined.

Methods: The incremental cost-effectiveness ratio (ICER) of MR imaging among ASNHL patients was evaluated using a decision tree.

Facial fracture repair and diabetes mellitus: An examination of postoperative complications.

Objectives/hypothesis: Our objectives included using a nationally representative resource to evaluate charges, demographics, and complication rates among diabetics undergoing surgical repair of facial fractures.

Methods: We evaluated the Nationwide Inpatient Sample, a database encompassing nearly 8 million hospitalizations, for patients with a diagnosis of a facial fracture who underwent surgical intervention during their hospitalization. Patients were organized by whether they had a diagnosis of diabetes mellitus (DM).

Pediatric pituitary resection: characterizing surgical approaches and complications.

Background: Although there has been extensive study evaluating adult pituitary surgery, there has been scant analysis among children. Our objective was to evaluate a population-based resource to characterize nationwide trends in surgical approach, hospital stay, and complications among children undergoing pituitary surgery.

Methods: The Kids' Inpatient-Database (KID) files (2009/2012) were evaluated for pituitary gland excisions.

Soccer-Related Facial Trauma: A Nationwide Perspective.

Purpose: Soccer participation continues to increase among all ages in the US. Our objective was to analyze trends in soccer-related facial injury epidemiology, demographics, and mechanisms of injury.

Materials And Methods: The National Electronic Injury Surveillance System was evaluated for soccer-related facial injuries from 2010 through 2014.

Consumer product ingestion and aspiration in children: A 15-year review.

Objectives/hypothesis: Our objectives were to identify consumer product (CP) ingestion and aspiration trends. Our hope is that evaluation of contemporary trends may be useful to physicians and policy makers and further guide preventative measures.

Methods: The Consumer Product Safety Commission's National Electronic Injury Surveillance System was queried for pediatric CP aspiration and ingestion data for the years 2000 to 2014.

Cost-effectiveness of routine computed tomography in the evaluation of idiopathic unilateral vocal fold paralysis.

Objectives/hypothesis: To evaluate the cost-effectiveness of routine computed tomography (CT) in individuals with unilateral vocal fold paralysis (UVFP) STUDY DESIGN: Health Economics Decision Tree Analysis METHODS: A decision tree was constructed to determine the incremental cost-effectiveness ratio (ICER) of CT imaging in UVFP patients. Univariate sensitivity analysis was utilized to calculate what the probability of having an etiology of the paralysis discovered would have to be to make CT with contrast more cost-effective than no imaging. We used two studies examining findings in UVFP patients.

Does formal research training lead to academic success in otolaryngology?

Objectives/hypothesis: To evaluate whether formalized research training is associated with higher researcher productivity, academic rank, and acquisition of National Institutes of Health (NIH) grants within academic otolaryngology departments.

Methods: Each of the 100 civilian otolaryngology program's departmental websites were analyzed to obtain a comprehensive list of faculty members credentials and characteristics, including academic rank, completion of a clinical fellowship, completion of a formal research fellowship, and attainment of a doctorate in philosophy (PhD) degree. We also recorded measures of scholarly impact and successful acquisition of NIH funding.

Establishing a danger zone: An anatomic study of the lingual artery in base of tongue surgery.

Objectives/hypothesis: To contrast the changes in measurement of the hypoglossal/lingual artery neurovascular bundle (HLNVB) to constant surface landmarks in the base of tongue (BOT) during surgically simulated retraction versus resting anatomic position, and to identify a safe zone for BOT robotic surgery to avoid injury to the HLNVB.

Study Design: Human cadaver study.

Methods: Five fresh-frozen head and neck complexes were obtained, and seven HLNVBs were dissected.

Adding Injury to Insult: A National Analysis of Combat Sport-Related Facial Injury.

Objectives/hypothesis: To estimate the incidence of patients presenting to emergency departments (EDs) for facial trauma sustained from participation in combat sports and evaluate injury patterns and patient demographics.

Methods: The National Electronic Injury Surveillance System (NEISS) was evaluated for facial injuries from wrestling, boxing, and martial arts leading to ED visits from 2008 to 2013. Relevant entries were examined for injury mechanism, location, type, as well as other patient characteristics.

The Vicious Cycle: Pediatric Facial Trauma from Bicycling.

Objectives: Although prevention of head injuries through helmet use is widespread, there has been a paucity of inquiry and publicity regarding the potential for facial injury stemming from cycling. Our objectives included estimating the incidence of emergency department (ED) visits for bicycle-related facial trauma among the pediatric population and detailing injury patterns.

Study Design And Setting: Analysis of a nationwide database.

Scholarly investigation into otitis media: who is receiving funding support from the National Institutes of Health?

Objectives/hypothesis: Otitis media (OM) is highly prevalent and represents a major public health concern. We evaluate National Institutes of Health (NIH) funding support for OM research and examine the role of otolaryngology primary investigators (PIs).

Study Design: Examination of bibliometrics and funding history of NIH grant recipients.

Burns in the head and neck: A national representative analysis of emergency department visits.

Objectives/hypothesis: Head and neck burns (HNBs) engender serious sequelae including airway edema, speech/swallowing dysfunction, sensory deficits, and scarring/disfigurement, often requiring significant reconstructive surgery. We used a nationally representative resource to estimate the number of visits to emergency departments (EDs), analyze burn types and demographic patterns, and identify specific consumer products involved.

Methods: The National Electronic Injury Surveillance System was evaluated for the most recent 5-year period available.

Craniofacial Surgery and Adverse Outcomes: An Inquiry Into Medical Negligence.

Objective: This study aimed to evaluate factors contributing to medical negligence relevant to craniofacial surgery.

Methods: Retrospective analysis of verdict and settlement reports on the Westlaw legal database for outcome, awards, physician defendants, and other specific factors raised in malpractice litigation.

Results: Of 42 verdicts and settlement reports included, 52.

Protecting the airway and the physician: Aspects of litigation arising from tracheotomy.

Background: In recent decades, medical malpractice costs have increased and have led to a change in the way physicians practice medicine. Tracheotomies are cases in which complications have a high risk of morbidity and mortality and the potential for litigation.

Methods: The Westlaw legal database was used to gather data on 43 jury verdicts and settlements from 1987 to 2013.

Cleft palate: a clinical review.

Orofacial clefts, including cleft palates (CP), are one of the most common birth defects. CP have a multiplicity of effects on the individual and society in terms of economic costs, loss of productivity, psychosocial effects, and increased morbidity and mortality at all stages of life. Embryological development of the palate is well delineated, with developments in the last decade regarding the biomolecular processes involved.

Evaluation of otolaryngology residency program websites.

Importance: Prior to applying or interviewing, most prospective applicants turn to the Internet when evaluating residency programs, making maintenance of a comprehensive website critical. While certain "intangibles" such as reputation may not be communicated effectively online, residency websites are invaluable for conveying other aspects of a program. Prior analyses have reported that certain criteria such as research experience and didactics are important considerations for applicants.

Unattractive consequences: litigation from facial dermabrasion and chemical peels.

Background: Facial dermabrasion and chemical peel are common cosmetic procedures that are generally safe yet do possess inherent risks. The patient's expectations, formed well in advance of treatment, strongly correlate with overall satisfaction.

Objectives: The authors reviewed and analyzed litigation related to the performance of facial dermabrasion and chemical peel.

Cleft lip - a comprehensive review.

Orofacial clefts comprise a range of congenital deformities and are the most common head and neck congenital malformation. Clefting has significant psychological and socio- economic effects on patient quality of life and require a multidisciplinary team approach for management. The complex interplay between genetic and environmental factors play a significant role in the incidence and cause of clefting.

Angiosarcoma of the scalp with complete response to a biweekly gemcitabine and docetaxel (GEMDOC) chemotherapy regimen.

Angiosarcoma is a rare, aggressive soft-tissue sarcoma with a high rate of recurrence and distant metastasis. Only a few cases of angiosarcoma involving the scalp have been reported in the literature. We describe a case involving a 75-year-old woman who presented to the emergency department at the Detroit Medical Center with multiple painful scalp lesions.